The U.S. Supreme Court has denied certiorari in a petition brought by Maryland ElderLawAnswers member attorney Ron M. Landsman, asking the court to review a Florida appeals court ruling that the state is not required to deduct all of a Medicaid applicant's pre-eligibility nursing home expenses from the applicant's income when calculating the applicant's monthly contribution to nursing home costs.
The case involved Gabrielle Goodwin who entered a nursing home after injuring her spinal cord. She argued that the state should have deducted all of her unpaid, pre-eligibility nursing home expenses -- about $70,000 -- from her income before determining how much she was required to contribute to her cost of care. Instead, the state determined that federal regulations required the state to deduct medical care not covered under the state's Medicaid plan and that Ms. Goodwin's care was covered. In Goodwin v. Florida Department of Children and Families (Fla. Ct. App., 1st Dist., No. 1D12-4430, April 4, 2016), the court ruled that because the "Medicaid program routinely includes and covers the nursing home care that Ms. Goodwin received" before becoming eligible for Medicaid, the state properly considers them Medicaid-covered expenses.
In the petition for certiorari, Landsman argued that Florida's decision in Goodwin diverges from both CMS's interpretation of federal Medicaid law and courts that have previously considered the question. The Supreme Court denied certiorari without comment.
Landsman has a record of successfully litigating this issue, reaching settlements in Tennessee and Maryland that required the states to deduct pre-eligibility medical expenses from Medicaid recipients' patient pay amounts.
Subscribe to the Knowledge Bank.
